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Media Statement: New survey highlights extent of home care fragility in Scotland

A fresh warning has been issued to national and local government about the consequences of failing to support home care services across Scotland.

Scottish Care, the representative body for independent providers of social care, is calling for a renewed approach to supporting and funding care at home services in 2018 to prevent the collapse of the sector, which would have a huge impact on many of Scotland’s most vulnerable citizens.

The warning comes on the back of new survey data published by Scottish Care today (THURS 11 JAN) which shows that:

  • Nearly 40% of care at home services handed work back to Local Authorities in 2017 on the basis of sustainability and capacity
  • Half of home care services did not apply for contracts offered by their Local Authority in 2017 on the same grounds
  • 86% of home care services are concerned about their sustainability and survival in 2018, with nearly a quarter extremely concerned

The responses to the survey, which was undertaken in the week before Christmas, represents nearly 6,000 home care staff delivering 133,000 hours of care to over 12,000 people per week.

Scottish Care’s Executive and National Committees will meet today in Glasgow to discuss these findings and their implications for the ongoing care of adults and older people in their own homes.
Speaking ahead of this meeting, Scottish Care CEO, Dr Donald Macaskill, said:

“Unfortunately, these findings only serve to consolidate what we already know and what we have been telling Scottish Government, Health & Social Care Partnerships and commissioners throughout 2017.

“We are not crying wolf when we stress the precarious nature of home care in the current climate, with the results of this survey emphasising how genuinely close to collapse we are in Scotland.

“It shows that half of the services we represent feel unable to compete for contracts because the rates and conditions at which they are set by Local Authority make the delivery of dignified care impossible to sustain. And of those who do try to make it work, 40% are forced to hand that work back because it is not viable to continue operating.

“It means we have a huge number of home care services willing and able to provide high quality care in people’s own homes but who are stifled from doing so by a drive to the bottom by Local Authorities in terms of pay and conditions offered to those services delivering that care. The inability of services to recruit and retain staff and to pay them a good wage further cripples these essential services. We are faced with a reality where a quarter of services are not sure they will still be operating this time next year.

“The present crisis being faced by the NHS is being made much worse by the failure to integrate properly, and to dedicate equal resource and focus to social care. We can no longer tinker around the edges of social care – the challenge needs to be grasped with both hands and driven forward by a political will to ensure there are a range of high quality, sustainable services available in people’s communities which also offer attractive careers for the 1 in 13 Scots who are employed in social care.

“If this doesn’t happen now, the consequences are enormous for health and social care, for the economy, for jobs and most importantly, for the tens of thousands of individuals and families who rely on this type of support.

“It is all very well to join up health and social care systems on paper and as structures. But real partnership which puts people at the centre needs to be worked at not just spoken about. We need to work very hard in 2018 to ensure we still have a social care system able to care for our vulnerable older citizens. At the moment this survey suggests that there are worrying signs that we will not.”

To read the full report, click here.

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Recruitment, retention, regulation and representation: The 4 R’s survey

Throughout 2017, recruitment and retention challenges intensified for care home, care at home and housing support organisations throughout Scotland.  With the demand for adult social services increasing, how can providers best attain the new National Health and Care Standards, meet regulatory and registration qualification requirements and attract and retain a dedicated, compassionate workforce in 2018?

We have created a short survey for Scottish Care members which should take no longer than 10-15 minutes to complete.   This survey does not look for detailed data about your service but instead asks you to provide qualitative information about your experiences, thoughts, ideas and solutions relating to recruitment, retention, regulation and representation.

Access the survey here: https://www.surveymonkey.co.uk/r/4RSurvey

We aim to use the information provided to clearly articulate your experiences of providing care in Scotland – and to positively influence policy makers at a local and national level.

The findings of this survey will be launched at an event in Glasgow on Thursday 15th March.  More information about this event will be circulated in the next week.

We very much appreciate you taking time to complete this survey.  Please complete one response per service, not per organisation.

The survey will close on Wednesday 31 January.

If you have any questions please don’t hesitate to contact Becca Gatherum – [email protected].

Thank you

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2018 as the Year of Social Care

Let’s make 2018 the Year of Social Care

In one of the most famous broadcasts since the start of radio, George VI used the words of the poet Minnie Haskins to start the New Year in 1939

‘And I said to the man who stood at the gate of the year:
‘Give me a light that I may tread softly into the unknown.’

These words were uttered at a point in history of great uncertainty, fear and alarm at the start of the year which would see the horrors of the Second World War start to unfold.

They are also words which over time became synonymous with the start of the year, with the sense of journeying into a future which was undetermined and full both of potential and challenge.

To some degree every New Year message from politician and commentator alike has combined a mixture of reflective analysis of the year that has past and a consideration of both the challenge and the potential of the year that is to come. The recent flurry in the last few days of such messages from Scottish politicians has tended to concentrate on the extent to which 2018 is a year which because it is the Year of Young People will enable us to focus on the contribution of the young to moulding our modern Scottish society.

In this message at the start of 2018 I would like to suggest that 2018 should be the Year of Social Care – regardless of the age of those who might be in need of the essential life enabling support and care which social care offers.

I do so well aware that in 2018 we will witness the 70th anniversary of the NHS in the United Kingdom. That celebration will help us to focus on the amazing contribution which the NHS and those who work in it have made to ensuring the health and wellbeing of our communities. Over the last 70 years we have seen extra-ordinary advances in care and treatment which have helped eradicate many of the diseases which formerly scarred society, control many others and result in astonishing progress in life expectancy and the quality of life for countless millions. So, 2018 will indeed be a year to celebrate the NHS.

But we are increasingly aware of the interdependency of social care with the clinical health system represented by the work of the NHS. The integration of health and social care in Scotland underlines a reality that we have long been aware of – namely that a failure in one part of the health and care eco-system, including a failure to adequately resource, has profound impact on another connected area. At the present time, the impact of the flu epidemic which is putting strain on the NHS, stretching A&E services, and impacting on delayed discharge is evidenced in the related struggles to arrange packages of social care to enable people to be discharged and to be supported at home or in a homely setting.

The celebration of the NHS reaching 70 will be somewhat hollow and vacuous if it is against a backdrop of the sounds of a disintegrating and deteriorating social care system.

Social care in Scotland is at a crossroads as we move into 2018.

Regular readers of these blogs will be well aware that throughout 2017 I have been warning of the ‘crisis’ facing social care. We have 9 out of 10 home care providers struggling to recruit staff and in the last few weeks faced with increased staff illness, the challenge of the better-paid retail sector, and ever shortening time-slots in which to deliver dignified care – home care providers have been really challenged to keep the show on the road and deliver urgent care and support at the point of need, no matter how isolated those locations might be.
Our care home providers faced with a vacancy level of 31% for nurses, nearly a quarter of care staff leaving the sector last year and with the already real living nightmare of Brexit, they are continuing to deliver increasingly high-quality care to some of our most vulnerable citizens in palliative and end of life contexts and to individuals living with the challenges of advanced dementia.

We have, in Scotland, so much which is full of potential and promise. Staff who are quite simply astonishingly professional and multi-skilled despite being paid basic wages. Legislation around Self-directed Support which has the potential of giving real choice and control to the individual citizen, which builds support around the person rather than the needs of the system. We have the start of the Health and Social Care Standards which have human rights at their heart and which if properly implemented and supported will help to advance care. We have new legislation which seeks to put carers at the heart of an effective and resourced support system in recognition of their critical contribution. The potential therefore is evident – the challenge in 2018 is to realise that potential.

As I write this piece our politicians are discussing and debating the Budget proposals of the Scottish Government. Despite my own call for a 3-year urgent investment of £1 billion pounds in the whole social care system, that Budget has promised only an additional £66 million to ensure the reforms, developments and delivery of this critical part of our social fabric. I hope the politicians who do have influence hear the urgent calls for further substantial investment in social care in Scotland. We can no longer tolerate the shame of 15 mins visits, where dignified end of life care and support, where the opportunity of personal care, is being crowded out by the budgets of austerity which affect the old, infirm and dying most sharply. We can no longer as we move into 2018 consider it acceptable that your chronological age has become the determinant of whether you get the opportunities to live a meaningful and independent life.

‘And I said to the man who stood at the gate of the year:
‘Give me a light that I may tread softly into the unknown.’

2018 needs to be the Year of Social Care in Scotland. A year when as a society we make the choice to value those who care and the work of care as making an essential contribution to Scotland rather than being a drain on our nation; where we celebrate the astonishing dedication and skill of the 10s of thousands who today care for our fellows in challenging, emotional and draining circumstances by properly rewarding them; and when we adequately resource social care especially for our vulnerable old to enable them to live life to the full and to die well.

Our political leaders have the opportunity of leading us into that future or merely standing still at the gate.

Dr Donald Macaskill
@DrDMacaskill

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Latest Blog from our National Director, Karen Hedge

Happy New Year and Welcome to 2018.

Within the context of New Year’s Resolutions, and the focus on caring for and creating the ‘better you’ peddled within any one of the many self-help books promoted at this time of year, I see a shift from a focus on having less, to a focus on having more. To be health-‘ful’ by limiting what you give your body, to have more time by limiting how you use your time, to be richer by limiting how, where and when you spend your money: they all require a fine balance so close to being contradictory, and in complete contrast to the holiday feasting.

It’s an analogy which I see, in this time of austerity, being applied across the health and social care sector. Not to focus on cuts, but to focus on what we have and what we can do within that context. And whilst this appears to be a laudible approach, I have not yet found an ‘off-the-shelf’ self-help book on the health and social care sector.

This is because missing from the discussion is the reality that we have been working at this for over eight years now. At what point can we say that we have applied all of the efficiencies possible? Not to say that there is no place for review, but that a focus on what can be saved now leaves the sector exposed to the real risks associated with a failure to future proof.

Last  month I had the privilege to hear Professor Gillian Ruch speak at the Social Work Summit. She spoke about relationship-based approaches to service delivery, and raised the concept of austerity as an ideological choice about making budgets balance, not about looking at the needs of the population.

Often when we plan for our sector, we think about celebrating our aging population who may use health and social care services. But what we need to be aware of is that we also need to celebrate and value our aging workforce without whom the sector as a whole risks folding. Consideration then must also be given to the necessary interaction with and effect of this on the rest of the population, especially given the economic contribution of a sector which employs 1 in 13 Scots. But this has to happen not just in relation to workforce planning, but to all of the aspects of health and social care. To plan for the sector as a whole, we must to consider the needs of the population as a whole.

If carefully and thoughtfully planned, implemented and resourced, there are currently many opportunities for the sector; the reform of many of our partners, the new health and social care standards, self-directed support, integration, and so on. But my concern is that the pre-requisite context is not a given, and the current impact of winter on an already under-resourced and under-valued sector, means that change will come too late.

At the time of writing, we await the response of the Health and Sport Committee to the evidence given in relation to the ‘Save Our Bield’ campaign. Whilst I support the call to create an independent commission to review the crisis in the Scottish care home sector, I am wary that to consider the outcomes of this in isolation from the sector as a whole – from care at home through to acute provision – would be limiting and wasteful. What happens in one part of the sector will inevitably affect another, inevitably affecting the citizens of Scotland. And so the pressure is on to consider our vision for the future of care as a whole; a vision which values our population as a whole, the sector as a whole, and the contribution that it makes to the population of Scotland as a whole.

#careaboutcare

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Guest Post from Local Integration Lead, Brian Polding-Clyde

Notes from Japan

For the last three years I have been involved in a consortium of people delivering dementia awareness in West Dunbartonshire. We have people from; HSCP, CVS, RNIB, Alzheimer Scotland and myself involved in this work with the aim of developing a dementia friendly West Dunbartonshire.  Initially this work was something that grew out of a network of like-minded individuals working together. We applied for and were given a grant by the Life Changes Trust to further develop this work and that is how I came to visit Japan in the spring to present this work. We were invited to submit an abstract of the work which we duly did with no real thought of this coming to anything. However in a surreal week we were told that our abstract had been accepted by Alzheimer’s Disease International (ADI) and the Life Changes Trust noted that they would fund a member of our group to attend the Conference.

I discussed this work with my colleagues who agreed that it should be myself who attended the conference. Life Changes Trust agreed to support me in attending the conference and Scottish Care likewise agreed to support my attendance.  I was overwhelmed and delighted at the thought of attending.

The conference lasted from 26th to 29th April and was held in the same conference centre where the Kyoto climate agreement was signed. The days were packed from 7.00-18.00 with speakers from across the world. When people found out you were from Scotland they wanted to know about the fantastic work happening there. They knew about Dementia Friendly Communities and were intrigued by Promoting Excellence, with many taking away copies of materials or links to it. Since returning, my postage bill has been massive with copies of materials being sent to Singapore and beyond.  The model of partnership working to deliver dementia awareness across a community was held up as a model of best practice, with many delegates looking to discuss how we got the buy-in from partners to work in this fashion.  This made me reflect on our approach that I took for granted. All of the partners I worked with had been willing to work in a coordinated fashion to support the development of a dementia friendly West Dunbartonshire. 

It was overwhelming to hear the high esteem with which the people from across world hold Scotland when it comes to dementia awareness. I am aware that Scotland has been on a journey in relation to dementia care and I am proud to part of the journey within West Dunbartonshire but I see the work to do rather than what has been achieved. I became a dementia ambassador over five years ago and subsequently a Dementia Champion and Friend to help with this work.

Whilst in Japan I also had the opportunity to meet up with people I have been corresponding with from other continents. One of them Rebekah Churchyard, from Canada, has an interest in Dementia and Criminal Justice and hearing her talk live and meeting up for the first time was an unexpected bonus.  This has sparked a new area of interest for me in relation to the nature of people living with dementia who are involved in criminal justice.

Since travelling to Japan I have completed two MOOC’s (Massive Open Online Course) Preventing Dementia and Understanding Dementia with the University of Tasmania, which I learned about from attendance at the conference.  

Going to Japan has helped me to put some of the achievements Scotland and West Dunbartonshire have made into context.  I have been more aware of work still to do and I have become more appreciative of the journey we have made in West Dunbartonshire.

Brian Polding-Clyde

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A Message from our CEO: A Christmas Thank You

Thank you …

As Christmas Day gains momentum across the country the chorus of thank you’s will become louder in homes up and down the land.

As children with eager-eyed enthusiasm discover the capacity of Santa Claus to forgive their naughty actions.

As partners exchange just a token of what they mean to another.

As friends find wrapped in a gift an expression of their gratitude.

As families, close and familiar, occasional and detached, sit down to pull crackers, drink, share food, stories and gossip, hopes and dreams.

Christmas Day is indeed a day of thank you’s and a reminder of what we count as important in our living and loving.

So I want to add to the chorus of thank you’s…

Thank you to the homecare and housing support staff who have been out from early hours till late this evening bringing food and comfort, presence and a smile to someone who might see no one on this day. Thank you to all 60,000 plus of you.

Thank you to the staff who will serve meals, tender to the physical needs and enliven the hopes of the 33,000 people who are in a care home today. Thank you to the thousands of nurses and care home staff who are working today.

Thank you to the one who holds the hand of someone frightened and anxious as they come to the end of their life- your comfort is a gift beyond price.

Thank you to the one who through word, smile and encouragement gives a lifeline of hope when the dark fog of depression and mental distress freezes up a life.

Thank you to the one who stays longer than she should; who sacrifices her own family time to be with a lonely life; who brings the comfort of presence when the pain of aloneness is overwhelming.

Across Scotland let us hear the clamour of thank you’s to the thousands who are working today to care, to nurse, to heal and to give the gift of presence. We owe you a gift beyond purchase or price.

Thank you

Donald Macaskill

@DrDMacaskill

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Apprenticeship Levy & Modern Apprentices – Event

Apprenticeship Levy and Modern Apprentices

The Third Sector Employability Forum (TSEF) are funding a seminar on Thursday 18th January 2018 from 10am-3pm at The Prince’s Trust Wolfson Centre, 15 Carlton Place, Glasgow G5 9JP.

While the seminar is entitled Third Sector Workshop on Apprenticeship Levy it follows on from the event Scottish Care co-hosted in October alongside colleagues from CCPS and SCVO and we have had input to the day’s programme.

We would encourage members to come along, find out more about the Levy and Modern Apprenticeships, share experiences of both and help us to develop our approach as a sector.

Please follow the link to the Eventbrite page: https://www.eventbrite.co.uk/e/third-sector-workshop-on-apprenticeships-registration-41076572133

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Guest Post from Scottish Care Membership Support Manager, Swaran Rakhra

Mince Pies and Mulled-Over Wine!!

Well its nearly here, the adverts have been telling us since Halloween finished and we’ve seen plenty of premature Christmas trees peeking through the windows with their dazzling array of lights, and music playing within the shopping centres and on the radio – Yes it’s time to put on weight and blow all your earnings – Sorry what I meant to say is its Christmas time, a time for joy and celebration, as well as looking back as we face another year, at the year that’s gone and the year to come!

One film comes to mind at this jolly time, yip the Sound of Music, a firm favourite for families to sit around watching and singing along to the wonderful uplifting songs, whilst they sit uncomfortably full around the TV.

The song “Climb every mountain” rings true for me. Many years ago when I managed a Church of Scotland older person’s home in Helensburgh, we were celebrating the care home’s 40th anniversary. One of the many events we had was a fund raiser climbing Ben Lomond. Please note this is the one and only Munro I’ve ever climbed and whilst it was hard going up, coming down was also a challenge! My excuse now is a knee problem, honest!!

If it were not for one of my staff, who literally talked to me all the way up the mountain, which kept me focussed and from turning back, enabling me to concentrate on putting one foot in front of the other. Was it worth it? Yes; I emotively recall the moment as we looked down upon the vista of Loch Lomond, eating our well-earned sandwiches!!

Well, as you rightly will be asking, nice story and what has this to do with me, working hard within the social care sector? The parallels with climbing over obstacles – I found going up step by step a real problem. For many working within social care, this year has been a tough one (of many)! As I accompanied Donald on his tour of the branches within Scotland, common themes emerged: many providers face challenges of recruitment and retention of staff, continuity of business due to financial viability, stress of working within a seemingly over regulated care sector, dealing with complexity of care and an ever demanding commissioned service at low rates of reward, to name but a few. Many excellent providers have decided enough is enough and given up on the provision of care, having worked hard to provide quality care and employment. It has not been easy to make that decision, but forced into it by circumstances in many cases, out with their control. We hear within Scottish Care that this is now a common occurrence, with 9 out of 10 providers facing stress and major obstacles in continuity of service and care.

As was highlighted at our recent events for Home Care and Care Homes, this is a crucial time for our sector, and we need to work together in partnership (not necessarily harmony), as we walk up the social care mountain together. There are organisations like Scottish Care who are like that staff member who with her incessant talking, kept me company, encouraging and guiding me to take the next step, to watch for the pitfalls of a jutting rock or smelly bog, and just kept me going. We need to work and walk together with our partners to ensure that we are united in a common concern, keeping our head in reality, but looking upwards to our goal, just around that next bend!

Partnership does not just mean our sector, but those partners within Scottish Government, regulators like SSSC and the Care Inspectorate, Integration Boards, and those within health and social care to name a few. A recognition that we need to work together, putting aside differences, unblocking barriers and seeing beyond political mountains and obstacles. The people in Scotland deserve the best care and support we can offer, and this must be matched up with proper resourcing of funds, recognition for the important, complex work we undertake, and being regarded as equal partners within the care system. In this way we can indeed:

Climb every mountain,
Ford every stream,
Follow every rainbow,
‘Till you find your dream………..

In my last blog I mentioned my newly qualified niece, a nurse who chose to leave the NHS and work with older persons in the care sector. She still works there, and is investigating further academic possibilities within the sector. In addition my son in law worked for a large national retailer (one that’s open 24 hours a day!) but recently decided on a career change. He is now flourishing working in a care home. He loves being able to help those who need and deserve a kind heart.

So let’s stop the tide of folk leaving our sector, and encourage others to join us in a worthwhile compassionate job with the rewards of caring for many in their twilight years!

I wish you all a very Merry Christmas and hopefully a better New Year, so get those walking boots on, tie a rope round each other and together “climb that mountain”!

Swaran Rakhra

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Scottish Government Safe Staffing Legislation – Engagement Events

The Scottish Government has taken the decision at this stage to extend the Safer Staffing Legislation, which had initially been envisaged as relating solely to nursing, to the wider staffing of health and social care.

This decision, upon which Scottish Care is asking for greater clarification, is likely to have far reaching impacts on social care providers.

We have been alerted to engagement events to be held in the next few weeks and are keen that care home and home care/housing support providers are as well represented at these events as possible.  These are being advertised on a first come first served basis and we would encourage members to attend these as a matter of some priority.

Please use the three Eventbrite links to the engagement events below to register:

 

Aberdeen event – 5 February 2018

https://www.eventbrite.co.uk/e/scottish-government-safe-staffing-legislation-tickets-41307037461?utm_term=eventurl_text

 

Glasgow event – 7 February 2018

https://www.eventbrite.co.uk/e/scottish-government-safe-staffing-legislation-tickets-41307212986?utm_term=eventurl_text

 

Edinburgh event – 8 February 2018

https://www.eventbrite.co.uk/e/scottish-government-safe-staffing-legislation-tickets-41307246085?utm_term=eventurl_text